For many years, Charles Normand has been interested in how people can live well with chronic disease and how healthcare is increasingly about managing established chronic conditions. He now focuses on caring for and supporting people with complex needs, some of whom are near the end of life. In many cases, the best outcomes involve less of certain treatments—indeed, evidence suggests that people with the most complex multimorbidities live better for longer and cost less to care for when a more palliative approach is taken. This outcome can be achieved through expert assessments of people’s needs, especially when they are done early. Care needs (and costs) are strongly affected by family and social circumstances, and focused support and planning can help people remain at home when good informal care is available.
Brain health plays an important role in allowing people to remain at home and to live well with chronic diseases. There is a much closer relationship between brain health and care needs than there is for most chronic conditions. Better brain health not only has direct benefits on quality of life, but it can also be key to allowing people to live more independently and help support others in the household. Even small improvements can have major benefits in terms of independence and quality of life. Normand’s current research includes studies on the impact of expert decision-making on care choices and outcomes for people with life limiting conditions, the costs and outcomes for people who do not get palliative care, and long-term care trajectories using data from the Irish Longitudinal Study on Ageing. In collaboration with colleagues at Mount Sinai Hospital, he is also developing a large comparative study of the effects of aging and proximity to death for people with dementia and multimorbidity.
Bio: Charles Normand graduated with a bachelor’s degree in economics from the University of Stirling and a doctorate degree from the University of York. Most of his career has been spent teaching and conducting research at the University of York, University of Stirling, Queen’s University of Belfast, London School of Hygiene and Tropical Medicine, and most recently at Trinity College Dublin. For four years, he worked as the principal economist for Health and Social Services in Northern Ireland. He has been involved in hospital management in London and Dublin and has worked closely with policy makers across Europe, Canada, and Australia, as well as in Malawi, Tanzania, South Africa, and Bangladesh. Normand has wide ranging research interests in the economics of health and health care, but recently he has focused largely on aging, multimorbidity, and palliative care.